Provider Demographics
NPI:1538211313
Name:SULLIVAN WHITE, LAUREN A
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:SULLIVAN WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:ADELE
Other - Last Name:SULLIVAN WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7 WOOD DUCK CT
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840
Mailing Address - Country:US
Mailing Address - Phone:845-893-6141
Mailing Address - Fax:
Practice Address - Street 1:492 ROUTE 57 WEST
Practice Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882
Practice Address - Country:US
Practice Address - Phone:908-689-1000
Practice Address - Fax:908-689-4529
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05414600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker